Physical intimate partner violence among women reporting prior fertility treatment: a survey of U.S. postpartum women

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To determine the prevalence of physical intimate partner violence (IPV) among postpartum women reporting preconception fertility treatment compared to those who conceived without the use of assisted reproduction. Cross-sectional population-based study. Twelve U.S. states with at least a 50% PRAMS survey response rate. Postpartum respondents of the Centers for Disease Control (CDC) Pregnancy Risk Assessment Monitoring System (PRAMS) survey. Preconception fertility treatment utilization. Physical Intimate Partner Violence (IPV). Of the 43,999 respondents included in this analytic sample, roughly 2% reported physical IPV. Respondents reporting preconception fertility treatment (12.6%) were less likely to endorse physical IPV than those who conceived without fertility treatment exposure (OR 0.5, 95% CI 0.4-0.7). In the multivariate regression model, the odds of physical IPV were similar among postpartum women regardless of fertility treatment exposure (aOR 1.2, 95% CI 0.8-2.0). Residing in a household with an income under the federal poverty level and increased preconception stressors were predictive of reported physical IPV. There was no difference in type of fertility treatment and report of physical IPV. Among women exposed to fertility treatment, predictors of physical IPV included self-identification of Black (p<0.0001) or Hispanic (p=0.0352) race/ethnicity as well as report of 4 or more stressors in the 12 months prior to the most recent delivery (p<0.0001). The use of fertility treatment did not confer greater risk of physical IPV within this postpartum population. However, there are many individuals with infertility who never present for an assessment, proceed with treatment, or are unsuccessful, thus the extent to which infertility and fertility treatment exposure is associated with physical IPV remains to be elucidated. Women reporting a greater number of stressors may be uniquely at risk despite access and exposure to fertility treatment. The preconception period, inclusive of encounters with infertility specialists, represents a unique opportunity to screen and counsel all women for IPV.